Understanding online child exploitation: a public health perspective on online sexual abuse and exploitation of children (OSAEC) and child sexual exploitation and abuse materials in Quezon City and Manila

BACKGROUND: This study explores the factors contributing to online sexual abuse and exploitation of children (OSAEC) and the proliferation of child sexual exploitation and abuse materials (CSEAM) in Quezon City and Manila, two highly urbanized cities in the Philippines. METHODS: A mixed-methods approach was employed, combining quantitative surveys and qualitative focus group discussions (FGDs) and interviews. Data were collected from 100 participants in Quezon City and Manila, including healthcare professionals, community members, youth, parents, and child protection stakeholders. Quantitative data were analyzed using descriptive statistics and one-sample t-tests, while qualitative data from FGDs and interviews were examined through content and discourse analysis to identify key drivers of OSAEC and gaps in institutional response. Ethical protocols, including informed consent and child safeguarding measures, were strictly observed. RESULTS: Quantitative findings revealed strong consensus that key structural and social factors significantly contribute to children’s vulnerability to online exploitation. These include economic hardship and inadequate social safety nets (mean = 4.48), insufficient government initiatives on digital safety and OSAEC awareness (mean = 4.50), regulatory gaps governing online platforms (mean = 4.52), and weak local child protection mechanisms (mean = 4.57). Participants also emphasized the role of limited family cohesiveness (mean = 4.54) in increasing children’s exposure to online risks. Qualitative findings reinforced these results, highlighting how family dynamics, social norms, technological accessibility, and weak coordination among institutions collectively sustain a culture of silence and underreporting. CONCLUSION: The study underscores that OSAEC and CSEAM are multidimensional public health concerns rooted in socioeconomic vulnerability, regulatory lag, insufficient education, and fragile family and community systems. Despite existing laws, significant implementation gaps persist. The findings call for urgent, integrated, and multi-sectoral interventions, including strengthened social protection, comprehensive digital literacy programs, responsive regulation of online platforms, enhanced local child protection capacity, and family-centered support initiatives. A holistic and proactive public health approach, centered on the child and responsive to evolving digital risks is essential to effectively prevent online sexual exploitation and support survivors.